Skip to main content

Advertisement

Log in

Microvascular damage evaluation based on nailfold videocapillarosopy in sarcoidosis

  • ORIGINAL ARTICLE
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract    

Objectives

Microvascular damage is thought to play a role in the pathogenesis of sarcoidosis. We aimed to evaluate the nailfold capillaroscopy (NVC) pattern to detect microvascular changes in patients with sarcoidosis and the relationship of capillaroscopic parameters with clinical variables and disease-related measurements.

Patients and methods

Forty-two patients with sarcoidosis and 42 age- and sex-matched patients with systemic sclerosis (SSc) and healthy individuals were included in this cross-sectional case–control study. Patients aged 18–80 years who met the current American Thoracic Society criteria for sarcoidosis were included. NVC was performed by a digital microscope under a magnification of × 200. Capillary density, number of dilated, giant and neoangiogenic capillaries, capillary loop diameter, capillary shape, micro-hemorrhages, and number of avascular areas, were evaluated by an assessor who was blind to the groups allocation.

Results

Among the capillaroscopic parameters, neoangiogenesis and dilated capillaries, which can be seen in the pattern of scleroderma, were detected in patients with sarcoidosis but not significantly different from the control group (p = 0.055; p = 0.433, respectively). The rate of tortuosity and crossing capillaries of 50% and above was significantly higher in the sarcoidosis group than in SSc and healthy controls (p < 0.05). In patients with sarcoidosis, the only statistically significant finding was; forced expiratory volume (FEV1) in one second was lower in patients with a crossed capillary rate > 50% than in patients with a crossed capillary rate of less than 50% (FEV1; 87.21 ± 19.3, 102.5 ± 14.8, p = 0.04; respectively).

Conclusion

Patients with a diagnosis of sarcoidosis have different capillaroscopic patterns. The presence of these nonspecific abnormal patterns may reflect microvascular damage in the pathophysiology of sarcoidosis.

Key Points

• Microvascular damage may play a role in the pathogenesis of sarcoidosis.

• There may be some nonspecific abnormal findings in capillaroscopy findings in sarcoidosis.

• Capillaroscopy may be valuable in reflecting sarcoidosis lung injury.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Arkema EV, Cozier YC (2018) Epidemiology of sarcoidosis: current findings and future directions. Ther Adv Chronic Dis 9(11):227–240. https://doi.org/10.1177/2040622318790197

    Article  PubMed  PubMed Central  Google Scholar 

  2. Crouser ED, Maier LA, Wilson KC, Bonham CA, Morgenthau AS, Patterson KC et al (2020) Diagnosis and detection of sarcoidosis. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 201(8):e26–e51. https://doi.org/10.1164/rccm.202002-0251ST

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Takemura T, Matsui Y, Oritsu M, Akiyama O, Hiraga Y, Omichi M et al (1991) Pulmonary vascular involvement in sarcoidosis: granulomatous angiitis and microangiopathy in transbronchial lung biopsies. Virchows Arch A Pathol Anat Histopathol 418(4):361–368. https://doi.org/10.1007/BF01600167

    Article  CAS  PubMed  Google Scholar 

  4. Tuleta I, Skowasch D, Biener L, Pizarro C, Schueler R, Nickenig G et al (2017) Impaired vascular function in sarcoidosis patients. Adv Exp Med Biol 980:1–9. https://doi.org/10.1007/5584_2016_203

    Article  CAS  PubMed  Google Scholar 

  5. Aciksari G, Kavas M, Atici A, Kul S, Erman H, Yilmaz Y et al (2018) Endocan levels and endothelial dysfunction in patients with sarcoidosis. Angiology 69(10):878–883. https://doi.org/10.1177/0003319718775283

    Article  CAS  PubMed  Google Scholar 

  6. Smith V, Cutolo M (2010) When and how to perform the capillaroscopy M Cutolo (ed.), Atlas of Capillaroscopy in rheumatic diseases, Elsevier Srl, Milano 33–42

  7. Smith V, Vanhaecke A, Herrick AL, Distler O, Guerra MG, Denton CP et al (2019) Fast track algorithm: how to differentiate a “scleroderma pattern” from a “non-scleroderma pattern.” Autoimmun Rev 18(11):102394. https://doi.org/10.1016/j.autrev.2019.102394

    Article  PubMed  Google Scholar 

  8. Smith V, Herrick AL, Ingegnoli F, Damjanov N, De Angelis R, Denton CP et al (2020) Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud’s phenomenon and systemic sclerosis. Autoimmun Rev 19(3):102458. https://doi.org/10.1016/j.autrev.2020.102458

    Article  PubMed  Google Scholar 

  9. Hunninghake GW, Costabel U, Ando M, Baughman R, Cordier JF, du Bois R et al (1999) ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis Vasculitis Difuse Lung Dis 16(2):149–73

    CAS  Google Scholar 

  10. Zhang Y, Du SS, Zhao M, Li Q, Zhou Y, Song J et al (2022) Chest high-resolution computed tomography can make higher accurate stages for thoracic sarcoidosis than X-ray. BMC Pulm Med 22(1):146. https://doi.org/10.1186/s12890-022-01942-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Karakaya B, van der Vis JJ, Veltkamp M, Biesma DH, Grutters JC, van Moorsel CHM (2022) ANXA11 rs1049550 associates with Löfgren’s syndrome and chronic sarcoidosis patients. Cells 11(9):1557. https://doi.org/10.3390/cells11091557

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Cattelan F, Hysa E, Gotelli E, Pizzorni C, Francesco Bica PF, Grosso M et al (2022) Microvasculer capilleroscopic abnormalities and occurrence of antinuclear autoantibodies in patients with sarcoidosis. Rheumatol Int 42(12):2199–2210. https://doi.org/10.1007/s00296-022-05190-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Pabst S, Karpushova A, Diaz-Lacava A, Herms S, Walier M, Zimmer S et al (2010) VEGF gene haplotypes are associated with sarcoidosis. Chest 137(1):156–163. https://doi.org/10.1378/chest.09-1003

    Article  CAS  PubMed  Google Scholar 

  14. Michalska-Jakubus M, Cutolo M, Smith V, Krasowska D (2019) Imbalanced serum levels of Ang1, Ang2 and VEGF in systemic sclerosis: integrated effects on microvascular reactivity. Microvasc Res 125:103881. https://doi.org/10.1016/j.mvr2019.103881

    Article  CAS  PubMed  Google Scholar 

  15. Hasseli-Frabel R, Hermann W, Sander O, Triantafyllias K (2022) Nailfold capillaroscopy-principles and clinical application. Z Rheumatol 81(4):313–322. https://doi.org/10.1007/s00393-022-01200-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Hermann W (2016) Capillary microscopy. Z Rheumatol 75(6):586–590. https://doi.org/10.1007/s00393-016-0150-y

    Article  CAS  PubMed  Google Scholar 

  17. Smith V, Beeckman S, Herrick AL, Decuman S, Deschepper E, De Keyser F et al (2016) An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases. Rheumatology(Oxford) 55(5):883–90. https://doi.org/10.1093/rheumatology/kev441

    Article  PubMed  Google Scholar 

  18. van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A et al (2013) Classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis 72(11):1747–1755. https://doi.org/10.1136/annrheumdis-2013-204424

    Article  PubMed  Google Scholar 

  19. Gorasiya AK, Mehta HH, Prakashey A, Dave M (2022) Nailfold capillaroscopy of healthy individuals - an observational study. Indian Dermatol Online J 13(5):600–605. https://doi.org/10.4103/idoj.idoj_80_22

    Article  PubMed  PubMed Central  Google Scholar 

  20. Laohaburanakit P, Chan A (2003) Obstructive sarcoidosis. Clin Rev Allergy Immunol 25(2):115–129. https://doi.org/10.1385/CRIAI:25:2:115

    Article  PubMed  Google Scholar 

  21. Rabahoğlu B, Oymak FS, Ketencioğlu BB, Tutar N, Gülmez İ, Yılmaz İ (2021) Frequency of peripheral blood eosinophilia and obstructive airway disease in sarcoidosis. Turk J Med Sci 51(6):3001–3007

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The manuscript has been read and approved by all the authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Şerife Şeyda Zengin Acemoğlu.

Ethics declarations

Disclosures

None.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Acemoğlu, Ş.Ş.Z., Türk, İ., Aşık, M.A. et al. Microvascular damage evaluation based on nailfold videocapillarosopy in sarcoidosis. Clin Rheumatol 42, 1951–1957 (2023). https://doi.org/10.1007/s10067-023-06582-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-023-06582-z

Keywords

Navigation